Apgar score of less than 7 at 5 minutes for birth at or after term

Clinical commentary

Apgar scores are clinical indicators of a baby’s condition shortly after birth. The score is based on 5 characteristics of the baby: skin colour, pulse, breathing, muscle tone and reflex irritability. Each characteristic is given between 0 and 2 points, with a total score between 0 and 10 points (AIHW 2018).

An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment, while a score of less than 7 indicates complications for the baby (AIHW 2018).

Apgar scores at 5 minutes of less than 7 are not specific to any condition and may reflect congenital anomaly, prematurity, perinatal infection, effects of drugs given to the mother for pain relief or anaesthesia, ineffective resuscitation or prolonged hypoxia before birth (Li et al. 2013).  Maternal factors such as increasing maternal age, obesity, maternal morbidity, especially diabetes, and maternal smoking during pregnancy, may contribute to a baby being born with a low Apgar score (Kharkova et al. 2017; Straube et al. 2010; Zhu et al. 2015).

Indicator specifications and data

Excel source data tables are available from the Data tab.

For more information refer to Specifications and notes for analysis in the technical notes.


  • AIHW (Australian Institute of Health and Welfare) 2018. Australia’s mothers and babies — in brief. Perinatal statistics series no. 34. Cat no. PER 97. Canberra: AIHW.
  • Kharkova O, Grjibovski A, Krettek A, Nieboer E & Odland J 2017. Effect of smoking behaviour before and during pregnancy on selected birth outcomes among singleton full-term pregnancy: A Murmask country birth registry study. International Journal of Environmental Research and Public Health 14(8):867.
  • Li F, Wu T, Lei X, Zhang H, Mao M & Zhang J 2013. The Apgar score and infant mortality. Public Library of Science 8(7):e69072. 
  • Straube S, Voigt M, Jorch G, Hallier E, Briese V & Borchardt U 2010. Investigation of the association of Apgar score with maternal socio-economics and biological factors: an analysis of German perinatal statistics. Archives of Gynecology and Obstetrics 282(2):135–141.
  • Zhu T, Tang J, Zhao F, Qu Y & Mu D 2015. Association between maternal obesity and offspring Apgar score or cord pH: a systematic review and meta-analysis. Scientific Reports 5:18386.